Effectiveness of SPT in Long term follow up after flap surgery - 1 year follow up study

Main Article Content

Sankari Mallaippan


Supportive Periodontal Therapy, Periodontal maintenance, Maintenance phase, Patient’s care, Patient’s health


Background: Periodontitis is a bacterially‐induced, chronic inflammatory disease that destroys the connective tissues and bone that support teeth. Active periodontal thearapy aims to reduce the inflammatory response, primarily through eradication of bacterial deposits. Following completion of treatment and arrest of inflammation, supportive periodontal therapy (SPT) is employed to reduce the probability of re‐infection and progression of the disease; to maintain teeth without pain, excessive mobility or persistent infection in the long term, and to prevent related oral diseases.
Aim: The aim of the study is to assess the periodontal stability during maintenance period; effectiveness of SPT in long term follow up after flap surgery.
Materials And Methods: A total of 100 subjects were included in this study. 50 females and 50 males were included, divided into 2 groups. Group 1: Non-Maintenance Phase (n=50); Group 2: Maintenance Phase (n=50). The Clinical parameters assessed were : GI (Gingival Index), PI(Plaque Index), PD(Probing depth), CAL(Clinical attachment loss), Gingival Bleeding index,Tooth mobility, Tooth loss. The Parameters were assessed at Baseline, 1 month, 3 months, 6 months and 1 year. Statistical analysis were carried out by using SPSS software 23.0
Results: The present study discussed Group 1: Non-Maintenance Phase (n=50); Group 2: Maintenance Phase (n=50). The Clinical parameters assessed were : GI (Gingival Index), PI(Plaque Index), PD(Probing depth), CAL(Clinical attachment loss), Gingival Bleeding index,Tooth mobility, Tooth loss. The Parameters were assessed at Baseline, 1 month, 3 months, 6 months and 1 year. For Gingival index, Plaque index, Probing depth, Clinical attachment loss, Gingival bleeding index, Tooth mobility, Tooth loss: Group 1: Non-Maintenance Phase; Group 2: Maintenance Phase are not significant at baseline and 1 month follow up p>0.05; are significant at 3 months, 6 months and 1 year follow up.

Conclusion: Periodontally compromised patients under reinforcement and maintenance phase (follow up) showed good results when compared to non-maintenance phase group subjects.

Abstract 205 | PDF Downloads 154


1. Carranza’s Clinical Periodontology, 11 Edition. By Newman, Takei, Klokkevold, Carranza
2. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of severe periodontitis in 1990– 2010: a systematic review and meta- regression. J Dent Res. 2014;93(11):1045- 1053
3. Clinical Periodontology and Implant Dentistry, Sixth Edition, Edited By Niklaus P Lang, And Jan Lindhe.
4. Periodontol A. AAP. Consensus Report: Periodontal diagnosis and diagnostic aids. In Proceedings of the World Workshop in Clinical Periodontics. ed. The American Academy of Periodontology 1989; Pp I/23-I/33.
5. Morrison EC, Ramfjord SP, Hill RW. Short-term effects of initial, nonsurgical periodontal treatment (hygienic phase). J Clin Periodontol. 1980 Jun;7(3):199-211. doi: 10.1111/j.1600-051x.1980.tb01963.x. PMID: 7000853.
6. Armitage GC, Xenoudi P. Post-treatment supportive care for the natural dentition and dental implants. Periodontol 2000. 2016 Jun;71(1):164-84. doi: 10.1111/prd.12122. PMID: 27045436.
7. Echeverría JJ, Manau GC, Guerrero A. Supportive care after active periodontal treatment: a review. J Clin Periodontol. 1996 Oct;23(10):898-905. doi: 10.1111/j.1600-051x.1996.tb00509.x. PMID: 8915017.
8. Axelsson P, Lindhe J. The significance of maintenance care in the treatment of periodontal disease. J Clin Periodontol 1981: 8: 281-94.
9. Vadivel JK, Govindarajan M, Somasundaram E, Muthukrishnan A. Mast cellexpression in oral lichen planus: A systematic review. J Investig Clin Dent. 2019 Nov;10(4):e12457.
10. Panda S, Jayakumar ND, Sankari M, Varghese SS, Kumar DS. Platelet rich fibrin and xenograft in treatment of intrabony defect. Contemp Clin Dent. 2014 Oct;5(4):550–4.
11. Mehta M, Dhanjal DS, Paudel KR, Singh B, Gupta G, Rajeshkumar S, et al. Cellular signalling pathways mediating the pathogenesis of chronic inflammatory respiratory diseases: an update. Inflammopharmacology. 2020 Aug;28(4):795–817.
12. Venkatesan J, Singh SK, Anil S, Kim SK, Shim MS. Preparation, Characterization and Biological Applications of Biosynthesized Silver Nanoparticles with Chitosan-Fucoidan Coating. Molecules [Internet]. 2018 Jun 12;23(6). Available from: http://dx.doi.org/10.3390/molecules23061429
13. Bhansali KJ, Balinge KR, Raut SU, Deshmukh SA, Senthil Kumar M, Ramesh Kumar C, et al. Visible light assisted sulfonic acid-functionalized porphyrin comprising benzimidazolium moiety for photocatalytic transesterification of castor oil. Fuel. 2021 Nov 15;304:121490.
14. Deepanraj B, Senthilkumar N, Mala D, Sathiamourthy A. Cashew nut shell liquid as alternate fuel for CI engine—optimization approach for performance improvement. Biomass Conversion and Biorefinery. 2022 May 1;12(5):1715–28.
15. Kamath M, Rao SK, Jaison, Sridhar, Kasthuri, Gopinath, et al. Melatonin delivery from PCL scaffold enhances glycosaminoglycans deposition in human chondrocytes – Bioactive scaffold model for cartilage regeneration. Process Biochem. 2020 Dec;99:36–47.
16. Paramasivam A, Priyadharsini JV. Novel insights into m6A modification in circular RNA and implications for immunity [Internet]. Vol. 17, Cellular & Molecular Immunology. 2020. p. 668–9. Available from: http://dx.doi.org/10.1038/s41423-020-0387-x
17. Li Z, Veeraraghavan VP, Mohan SK, Bolla SR, Lakshmanan H, Kumaran S, et al. Apoptotic induction and anti-metastatic activity of eugenol encapsulated chitosan nanopolymer on rat glioma C6 cells via alleviating the MMP signaling pathway [Internet]. Vol. 203, Journal of Photochemistry and Photobiology B: Biology. 2020. p. 111773. Available from: http://dx.doi.org/10.1016/j.jphotobiol.2019.111773
18. Nambi G, Kamal W, Es S, Joshi S, Trivedi P. Spinal manipulation plus laser therapy versus laser therapy alone in the treatment of chronic non-specific low back pain: a randomized controlled study. Eur J Phys Rehabil Med. 2018 Dec;54(6):880–9.
19. Manresa C, Sanz‐Miralles EC, Twigg J, Bravo M. Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis. Cochrane Database of Systematic Reviews. 2018(1).
20. Schoenmakers MG, Willems EJ, Slot DE, Van der Weijden GA. Success of supportive periodontal therapy in periodontitis patients—A retrospective analysis. International Journal of Dental Hygiene. 2022 May;20(2):318-27.
21. Trombelli L, Farina R, Pollard A, Claydon N, Franceschetti G, Khan I, West N. Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy: A systematic review and meta‐analysis. Journal of Clinical Periodontology. 2020 Jul;47:144-54.
22. Ramfjord SP. Maintenance care and supportive periodontal therapy. Quintessence Int. 1993 Jul;24(7):465-71. PMID: 8210315.
23. Cosgarea R, Eick S, Batori-Andronescu I, Jepsen S, Arweiler NB, Rößler R, Conrad T, Ramseier CA, Sculean A. Clinical and microbiological evaluation of local doxycycline and antimicrobial photodynamic therapy during supportive periodontal therapy: A randomized clinical trial. Antibiotics. 2021 Mar 9;10(3):277.
24. Soundarajan S, Rajasekar A. Comparative evaluation of combined efficacy of methylene blue mediated antimicrobial photodynamic therapy (a-PDT) using 660 nm diode laser versus Erbium-chromium-yttrium-scandium-gallium-garnet (Er, Cr: YSGG) laser as an adjunct to scaling and root planing on clinical parameters in supportive periodontal therapy: A randomized split-mouth trial. Photodiagnosis and Photodynamic Therapy. 2022 Sep 1;39:102971.
25. Yamashita Y, Mae M, Oohira M, Ozaki Y, Ohba S, Asahina I, Yoshimura A. Clinical efficacy and safety of antimicrobial photodynamic therapy in residual periodontal pockets during the maintenance phase. Pharmaceuticals. 2022 Jul 25;15(8):924.
26. Eke, P. I., Dye, B. A., Wei, L., Slade, G. D., Thornton -Evans, G. O., Borgnakke, W. S., … Genco, R. J. (2015). Update on Prevalence of Periodontitis in Adults in the United States: NHANES 2009 to 2012. Journal of Periodontology, 86, 611 –622.
27. Gomes, Sabrina Carvalho, Piccinin, F. B., Susin, C., Oppermann, R. V., & Marcantonio, R. A. C. (2007). Effect of Supragingival Plaque Control in Smokers and Never -Smokers: 6 - Month Evaluation of Patients With Periodontitis. Journal of Periodontology, 78(8), 1515 –1521. https://doi.org/10.1902/jop.2007.060462
28. Checchi L, Montevecchi M, Gatto MR, Trombelli L. Retrospective study of tooth loss in 92 treated periodontal patients. J Clin Periodontol. 2002;29(7):651–656.
29. Lee CT, Huang HY, Sun TC, Karimbux N. Impact of patient compliance on tooth loss during supportive periodontal therapy: a systematic review and meta‐analysis. J Dent Res. 2015;94(6):777‐ 786.
30. McFall WT Jr. Tooth loss in 100 treated patients with periodontal disease. A long‐term study. J Periodontol. 1982;53(9):539‐549.